Download presentation
Presentation is loading. Please wait.
Published byAshlee Page Modified over 9 years ago
1
Antibiotic, Antifungal, and Anti-helminthic Drug Indications (DOCs) Julia Jones (with fungal contributions from Wendy Chen)
2
Primary Syphilis Penicillin G, IM x 1 What if patient is very allergic to Penicillins? Doxycycline p.o. x 2wks
3
Staphylococci with plasmid- encoded β-lactamases Dicloxacillin
4
Pseudomonas Aeruginosa Piperacillin-Tazobactam What if patient is a little bit allergic to Penicillins? 3 rd gen ceph (ceftazadime) 4 th gen ceph (cefepime) What if patient is a lot allergic to Penicillins, cephalosporins? Aztreonam (monobactam) What if I wanted to use a protein synthesis inhibitor? Aminoglycosides What if that drug was too nephrotoxic? Aztreonam (monobactam) The Big Gun? Imipenem
5
Meningitis in patients >3 months old Ceftriaxone (IV, 3 rd GC) can add Vancomycin +/- Rifampin
6
Gonorrhea 3 rd GC Ceftriaxone (IM) or Cefixime (p.o.) What if very allergic to cephalosporins? ( 2 alternatives) FQs Azithromycin
7
Serratia Imapenem Aztreonam
8
EHEC None. Supportive/symptomatic
9
Typhoid Fever Ceftriaxone (serious G- infxn) Or? FQ, 2 nd line TMP/SMX
10
ETEC Severe G- infection: cephalosporin Severe G- rod aerobic infection: AG 2 nd line: TMP/SMX G- GI tract Tx: FQ
11
Shigella 1 st line: FQ 2 nd line: TMP/SMX Other? Amino-penicillin
12
Community-acquired pneumonia Azithromycin (ML) Plus? Ceftriaxone + AG
13
Nosocomial pneumonia Ceftriaxone + Gentamicin (aminoglycoside)
14
Serious Gram (-) infections Ceftriaxone
15
MRSA Vancomycin (sometimes add Gentamicin +/- Rifampin)
16
Mycoplasma pneumonia Doxycycline (tetracycline) Azithromycin
17
Enterobacter DOC? Imapenem Other choices? 2 nd /3 rd /4 th gen Cephalosporins Pipercillins
18
Chlamydia Doxycycline (+macrolide – azithromycin or erythromycin) How do I pick? depends on desired dosing regimen What other protein synthesis inhibitor? TMP/SMX
19
Rickettsia (RMSF) Doxycycline
20
Vibrio cholera Doxycycline
21
Legionella Doxycycline (+erythromycin)
22
Skin infections caused by community-acquired MRSA TMP/SMX What if allergic to sulfonamides? Doxycycline Other drugs? Clindamycin, FQs
23
Staph aureus drugs? Dicloxacillin Other drugs in this group? “I met a nasty ox:” Methicillin, Nafcillin, Oxacillin Vancomycin Clindamycin
24
Proteus Aminopenicillins All cephalosporins
25
Acinetobacter This used to be a pseudomonas Imepenem
26
Anthrax!! FQ This is actually the prophylactic Tx. Not DOC.
27
Lyme disease Doxycycline 3 rd gen cephalosporin
28
MAC (Mycobacterium avium) Azithromycin Ethambutol (FQ)
29
Hemophilis Amino-penicillins 2 nd /3 rd /4 th gen Ceph Aztreonam Chloramphenicol For prophylaxis? Rifampin Who gets it? All close contacts
30
Klebsiella All cephalosporins Aztreonam
31
Strep pneumo Penicillin Aminopenicillin + B-lactamase inhibitor Strep pneumo is notorious for what resistance mechanism? Altering PBP. Solution? 3 rd /4 th gen cephalosporins
32
Dental prophylaxis for endocarditis Clindamycin Aminopenicillins Rx for strep viridans/mutans? Penicillin
33
Lupus INH Ooh. Lupus is also a contraindication in which drug? Primaquine
34
Moraxella Amino-penicillin Azithromycin
35
Corynebacterial Diphtheria Macrolides (Azithromycin or Erythromycin) What else? Pen G/V
36
Anaerobic Abscesses Clindamycin or Metronidazole
37
Brain Abscesses Metronidazole
38
B.Frag Rx Metronidazole Imipenem (probably b/c this is a good Rx for mixed infections) What other drug is good for mixed infections? Clindamycin
39
Meningitis in a patient with a β- lactam allergy Chloroamphenicol
40
Strep Pyogenes? Pharyngitis Pen V what if allergic? Erythromycin
41
H.Pylori Amino penicillin + ML Or Doxycycline
42
Listeria meningitis Amino-penicillin
43
Adult sinusitis TMP/SMX Aminopenicillins
44
Nocardia TMP/SMX
45
Lower UTI TMP/SMX Upper + lower UTI FQ UTI d/t #1 cause in women E.Coli – AG UTI d/t #2 cause in women Staph saprophyticus--Dicloxaxillin
46
Chronic Bronchitis TMP/SMX
47
Prostatitis TMP/SMX
48
Pneumocystis Pneumonia TMP/SMX Prevention/prophylaxis? Caspofungin Prophylaxis in an AIDS patient? Dapsone
49
Pseudomembranous Colitis due to C. difficile Metronidazole (1 st choice) Vancomycin (2 nd choice) What caused it in the first place? Any antibiotic can cause. In real life, FQ is apparently the #1. In our class, #1 is Clindamycin, #2 is amino-penicillins
50
Prophylaxis for meningitis due to H. influenzae or N. meningitidis Rifampin Side effect: Orange Pee
51
DOC for TB (5 in order; adverse effects in parentheses) IRPES (rhymes with “herpes”) : INH (peripheral neuropathy – give Vitamin B6) Rifampin (orange bodily fluids; ramps up P450) PZA (gout) Ethambutol (visual disturbances; gout) Streptomycin (ototoxic; nephrotoxic)
52
Leprosy Dapsone + Clofazimine + Rifampin
53
Systemic fungal infections (especially life-threatening) Amphotericin B
54
Ringworm Terbinafine (could also include itraconazole or ketoconazole)
55
Tinea capitis in kids Griseofulvin
56
Prevention of cryptococcal meningitis in AIDS patients already on Amphotericin B Fluconazole
57
Cryptococcal meningitis Amphotericin B + Flucytosine (then maybe add fluconazole)
58
Coccidiodal meningitis Fluconazole (could also use intrathecal Amphotericin B)
59
Non-meningeal coccidiosis Ketoconazole
60
Non-meningeal histoplasmosis Itraconazole
61
Blastomycosis Itraconazole
62
AIDS patients on amphotericin B- stabilized histoplasmosis Itraconazole
63
Invasive aspergillosis (1 st & 2 nd line drugs) Itraconazole (1 st line) Caspofungin (2 nd line)
64
Chromoblastomycosis Flucytosine (alone)
65
Neutropenic patient with fever and unresponsive to antibiotics Amphotericin B
66
Induction of AIDS therapy Amphotericin B
67
Sporothrix schenkii Itraconazole
68
Systemic Candidiasis Amphotericin B (if this doesn’t work, then use Caspofungin) (if that doesn’t work, then use Fluconazole)
69
Localized candidiasis (oropharyngeal, esophageal, vaginal) Amphotericin B (oral/topical; “swish and swallow” for oropharyngeal; topical use for vaginal; nystatin) Itraconazole Ketoconazole (for mucocutaneous candidiasis) Fluconazole
70
Anti-fungal drugs eliminated by the kidney Fluconazole Flucytosine
71
Anti-fungal drugs eliminated by the liver Ketoconazole Itraconazole
72
Fungicidal Drugs Amphotericin B Caspofungin Terbinafine
73
Fungistatic Drugs Azoles Flucytosine Griseofulvin
74
IV only (or main method) Caspofungin (Amphotericin B is usually IV- administered; Candida is the only indication for oral/topical use)
75
Immunocompetent patient suspected of having histoplasmosis Do not prescribe anything (this was one of the questions in the syllabus… tricky)
76
Pinworm Mebedazole (1 st choice) Pyrantel (2 nd choice)
77
Hookworm Mebedazole (1 st choice) Pyrantel (2 nd choice)
78
Cestodes Praziquantel
79
Trematodes Praziquantel
80
Cysticercosis Albendazole
81
Cystic Hydatid Disease Albendazole
82
Cutaneous larva migrans Albendazole
83
Filiariasis Ivermectin (1 st choice) Diethylcabamazine (2 nd choice)
84
Loiasis (worms in connective tissue) Diethylcarbamazine
85
Tropical eosinophilia Diethylcarbamazine
86
Onchocerciasis Ivermectin
87
Strongyloidiasis Ivermectin
88
Schistosomiasis Praziquantel
89
Malaria (erythrocytic form) Chloroquine Mefloquine Doxycycline Atovaquone-Proguanil Arteminsinin
90
Malaria (P. vivax & P. ovale in liver) Primaquine
91
Amebiasis Metronidazole
92
Giardiasis Metronidazole
93
Trichomoniasis Metronidazole
94
Cyclospora Infections TMP/SMX
95
Email me about any corrections or DOC additions! - Julia (jonj5@mail.uc.edu)
Similar presentations
© 2025 SlidePlayer.com. Inc.
All rights reserved.